Journal of Medical Imaging and Radiation Sciences最新文献

{"title":"Pan-Canadian Assessment of Image Guided Adaptive Radiation Therapy and the Role of the Radiation Therapist","authors":"Winnie Li ,&nbsp;Amanda Moreira ,&nbsp;Yat Tsang ,&nbsp;Patricia Lindsay ,&nbsp;Peter Chung ,&nbsp;Tara Rosewall","doi":"10.1016/j.jmir.2025.101926","DOIUrl":"10.1016/j.jmir.2025.101926","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>Adaptive radiation therapy (ART) is a close-looped process where anatomic changes observed during treatment are identified, leading to plan modification prior to treatment delivery. With technological advances, ART is increasingly used in clinical practice, involving offline modifications between treatment fractions and real-time online adjustments. This study aims to assess ART practices across Canada and explore how these technologies affect the roles and responsibilities of Canadian Radiation Therapists (RTTs).</div></div><div><h3>Methods/Process</h3><div>A 30-question survey was emailed to RTT managers at all cancer centers in Canada (n=48). The questions covered center demographics, the presence of offline and/or online ART activities as standard care, roles and responsibilities of the multidisciplinary team, and training activities. Prior to distribution, the questionnaire was piloted for clarity and face validity by four RTTs with expert knowledge of the ART process. The survey was administered electronically and remained open for three weeks. Responses were analyzed using descriptive statistics. </div></div><div><h3>Results or Benefits/Challenges</h3><div>Thirty-two of 48 centers (67%) responded, representing all ten provinces. Of these, 25 centers (78%) practice ART, with all implementing offline ART and five also using online ART. Among the centers using offline ART, the brain was the least commonly treated site (56%), while head and neck treatments were adapted in almost all centers (except one). Five centers (16%) reported daily online ART, primarily for prostate patients, though brain, upper GI, and lower GI treatments were also adapted in some centers. The most common barriers to ART implementation were technical limitations and lack of resources. RTTs were responsible for 50% of offline ART tasks and 58% of online ART tasks, with the most significant change being the inclusion of target delineation in their daily responsibilities.</div></div><div><h3>Conclusions/Impact</h3><div>ART adoption varies across Canada, with offline ART more widely practiced than online ART, which is limited by technical and resource constraints. As centers adopt online ART, the roles of RTTs will need to evolve, focusing on upskilling to meet the demands of this emerging treatment paradigm.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101926"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Therapist-Driven MR-guided Adaptive Radiotherapy for Oligometastatic Disease","authors":"Amanda Moreira ,&nbsp;Winnie Li ,&nbsp;Iymad R. Mansour ,&nbsp;Mame Faye ,&nbsp;Ali Hosni ,&nbsp;Aruz Mesci ,&nbsp;Enrique Gutierrez ,&nbsp;Patricia Lindsay ,&nbsp;Peter Chung ,&nbsp;Jeff D. Winter","doi":"10.1016/j.jmir.2025.101927","DOIUrl":"10.1016/j.jmir.2025.101927","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>A major limitation in most adaptive radiation therapy (ART) applications is the need for daily, online re-contouring by radiation oncologists (RO) due to the associated human resource implications. This has been overcome for prostate MR-guided ART via successful implementation of radiation therapist (RTT) led workflows. With increasing utilization of MR-guided adaptive stereotactic body radiation therapy (SBRT) in oligometastatic disease, we evaluated a potential RTT-led workflow by comparing geometric accuracy and dosimetric uncertainty between RO and RTT re-contouring.</div></div><div><h3>Methods/Process</h3><div>Five RTTs and five ROs retrospectively re-contoured all target and organ-at-risk (OAR) volumes within a 2 cm ring of the target for eight oligometastatic disease cases. Consensus RO contours were generated for targets and OARs via the Simultaneous Truth and Performance Level Estimation (STAPLE) method and geometric accuracy was evaluated for each RTT and each RO contour versus the RO-STAPLE contour using Dice similarity coefficient (DICE) and Hausdorff mean distance to agreement (MDA). Additionally, a RO qualitatively scored all contours blinded to profession using a 5-point Likert scale. Furthermore, dosimetric impact of re-contouring was assessed against the RO-STAPLE contours using planning target volume (PTV) D95 and OAR D0.5cc. The Wilcoxon signed rank was used to determine statistical significance.  </div></div><div><h3>Results or Benefits/Challenges</h3><div>Mean (±standard deviation) GTV DICE were 0.82±0.06 for RTTs and 0.85±0.09 for ROs, and MDA was 0.88±0.03 mm for RTTs and 0.75±0.05 mm for ROs relative to the RO-STAPLE. Qualitative GTV scores were excellent with Likert scores of 4.8/5 for RTTs and 4.7/5 for ROs. Mean change in PTV D95 from RO-STAPLE small but statistically significantly higher for RTTs (0.5±1.5%) compared to ROs (-0.7±1.9%, p&lt;0.05). OARs assessed had high DICE and MDA scores for both RTTs and ROs. Dosimetric results for the OAR D0.5cc showed a mean relative change of –1.1±6% for RTTs and -1.1±12% for ROs. </div></div><div><h3>Conclusions/Impact</h3><div>Our results show that RTT re-contouring maintains similar performance for both targets and OARs compared with RO contours and establishes the feasibility of an RTT-led workflow. An RTT-led MR-guided online adaptive oligometastatic disease workflow has potential to decrease the resource burden for this valuable technique and improve access to MR-guided radiotherapy techniques. </div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101927"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creation of a Community of Research and Innovation in Radiation Therapy at a Community Hospital","authors":"Carrie Lavergne,&nbsp;Deanna Ng Humphreys,&nbsp;Shayne Allum,&nbsp;Amanda Ghazarian,&nbsp;Jenny Nguyen,&nbsp;Ruvette Coelho","doi":"10.1016/j.jmir.2025.101949","DOIUrl":"10.1016/j.jmir.2025.101949","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Research and innovation have been an ever-growing field at {our institution] since its opening in 2007. Since then, many oncology professionals, including radiation therapists (RTs) have spearheaded projects that led to improved patient experiences, increased departmental efficiencies and excellence in daily practice. As our department of RTs continues to grow, more and more RT-specific ideas on research and innovation were highlighted in departmental optimization meetings and topic-specific working groups, it became evident there was a need to create a space for RT-focused research and quality improvement initiatives.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;A group of research-interested RTs met in 2021 to brainstorm opportunities to create a supportive, centralized and uniform platform to support current and future RTs in pursuing research and process improvement initiatives. Due to COVID-19 restrictions, the group had to pause from 2021-2023, however then was reinstated once restrictions lifted. In 2023, the group met again and created an “SBAR” (Situation, Background, Assessment and Recommendation) document, with the recommendation to create a staff-led initiative to support RTs in pursuing research, innovation and quality improvements initiatives, with the goals of empower staff, encouraging and exploring new research opportunities, and increasing staff and student education and awareness around research. The SBAR was proposed and approved by the radiation oncology program and subsequently included on the 2024-2025 priority project board for the cancer centre.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;We have successfully created a small group of like-minded individuals, entitled “The Community of Research and Innovation in Radiation Therapy” (CORI-RT) who meet virtually monthly to support the endeavors outlined in our newly created terms of reference. This has included a terms of reference document. Although participation is still less than desired, we continually have more members join our community. We continue to seek new opportunities to increase uptake and participation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;We have made several improvements to our community, including organizing multiple RT program rounds with both internal and external speakers, presentations with RT students to encourage research, and support of new research and quality improvement projects. We are currently working on the creation of a virtual “hub” as a landing page to provide resources, updates and a space to ask questions and share information. We have made several improvements to our community, including organizing multiple RT program rounds with both internal and external speakers, presentations with RT students to encourage research, and support of new research and quality improvement projects. We are currently working on the creation of a virtual “hub” as a landing page to provide resources, upda","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101949"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating if Pre-Treatment Education Is Meeting the Needs of All Radiation Therapy Patients","authors":"Jina Min ,&nbsp;Alvin Cuni ,&nbsp;Michael Velec","doi":"10.1016/j.jmir.2025.101929","DOIUrl":"10.1016/j.jmir.2025.101929","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Pre-treatment radiation therapy education has been shown to support patients, reduce their anxiety and even improve their satisfaction with overall cancer care. Numerous approaches have been tested including self-directed learning with written pamphlets or videos, or 1-on-1 with a Radiation Therapist in-person or videoconferencing. As telephone-based patient education has been implemented since the COVID-19 pandemic, the aim was to evaluate if radiation therapy patients’ information needs are being achieved.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;As part of standard care, all patients received a 30-minute telephone consultation with a Radiation Therapist prior to their CT-simulation to review what to expect during their specific treatment course. For this prospective study approved as quality improvement, at CT-simulation patients were offered a questionnaire about the telephone consultation with implied consent for those who completed it. The 21-item questionnaire was designed to capture patients’ satisfaction with the information they received over the telephone (Likert-scale, 7 items), their preferences (e.g. timing/scheduling, in-person vs virtual modalities, mandatory vs optional) and demographic questions. Data was analysed with descriptive statistics and relationships between subgroups were explored with post-hoc tests (Chi-square, T-test, ANOVA).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Over two months 312 patients returned the survey, of which 278 were completed and included in this analysis. Overall mean Likert-scale scores were 4.10 (standard deviation 0.75) indicating patients agreed/strongly agreed the session help them prepare, new and sufficient information was provided, and they were comfortable speaking on the phone. Majority responded that the 30 min length (90.0%) prior to CT-simulation (60.4%) was optimal and that it should be mandatory (65.4%). Regarding modalities, 61.4% preferred the telephone (vs in-person, videoconferencing, etc.), although 52.5% indicated they would like additional information in short digital videos. There were consistent trends for those with lower education levels to report lower satisfaction, and they were significantly less comfortable receiving information over the telephone (p&lt; 0.05). More first-time patients versus those returning for re-irradiation indicated the session should be mandatory (71.1% vs 52.2%, p= 0.011), instead of optional. No other significant differences were observed by subgroup based on cancer type, age, gender, or race/ethnicity (p &gt; 0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;Patients reported overall that a pre-treatment telephone consultation with a Radiation Therapist provided them with new information that helped them prepare for radiation therapy. Results also indicate that a sizable minority of patients may benefit from tailored approaches for their level of comprehension, prior medical experience a","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101929"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Toxicity Grading and Management of Esophagitis for Radiotherapy Breast Cancer Patients","authors":"Kelsey Keobounma ,&nbsp;Dr. Aba Scott ,&nbsp;Catherine Shepherd ,&nbsp;Philip Shaheen ,&nbsp;Melanie Peters ,&nbsp;Nancy Sheaves ,&nbsp;Tegan Odland","doi":"10.1016/j.jmir.2025.101953","DOIUrl":"10.1016/j.jmir.2025.101953","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;An increase in the usage of prescriptions for pain-relieving mouthwash (PRM) for mild esophagitis has been noted in a population of breast cancer patients receiving radiotherapy with supraclavicular nodal irradiation in this institution. Between January 2023, to March 2024, 49% of patients were given PRM (either newly prescribed or were told to continue a previous prescription) to aid in altered eating/swallowing due to their radiation treatment. Typically, grade 2 esophagitis would require intervention, but this data showed PRM was given for grade 1 more commonly than grade 2. This is a problem as it goes against the standardized grading scale (CTCAE) guidelines and an expensive prescription which has a short shelf life should only be filled when necessary. The aim was to decrease the percentage of breast nodal radiotherapy patients with grade 1 esophagitis who are prescribed pain-relieving mouthwash from 58.3% to 15% within six months.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;An interdisciplinary team collaborated on how to improve congruency of prescribing based on the guidelines. An infographic was developed to guide radiotherapy team members in grading esophageal toxicities. Clinical educators reviewed it with both RNs and MRT(T)s and posted it in clinic areas. The study author led an education session, followed by a survey to gather feedback on the implementation. On weekly review, all breast nodal radiotherapy patients who were graded as grade 1 toxicity level and were given PRM were tracked. A comparison was made to the management and grading of patients treated during the few months preceding the study to determine trends after change ideas were implemented. The monthly percentage of patients prescribed PRM assessed at grade 1 esophagitis were graphed in a run chart.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;The benefit of this study is a reduction in unnecessary prescriptions following data driven quality improvement efforts. Staff were surveyed and reported empowerment with increased confidence in esophageal toxicity grading and sharpened toxicity assessment skills. The challenge of this study is that there is a small sample size that fluctuates based on the number of patients who are on active treatment for nodal breast radiotherapy in the department.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;A discrepancy between the toxicity grading levels reported and the guidelines indicating when interventions are required was initially observed. Only one month after introducing the infographic, the percentage of breast nodal radiotherapy patients with grade 1 esophagitis who were prescribed PRM decreased to 33%. The study is ongoing and further reduction in the percentage of patients prescribed PRM outside of guidelines is expected in the coming months. Prescribing PRM less often could alleviate the financial burden for patients who were purchasing prescriptions for mouthwash before tryin","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101953"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of an Automatic Contouring System within a Radiation Therapy Department","authors":"Shayne Allum","doi":"10.1016/j.jmir.2025.101947","DOIUrl":"10.1016/j.jmir.2025.101947","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;The observable increase in advanced palliative treatment plans and retreat patients adds to planning complexity, necessitating more contours within shorter timelines to accommodate urgent cases. To support the increased demand for complex palliative treatment cases and reduce slowdowns, an automatic contouring (AC) system was installed and integrated into the planning workflow. The goal was to improve contouring completion time by having CT simulation staff review, edit and approve automatically generated contours rather than generate them manually.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;An initial study assessed readiness, ease of use and end product outcomes prior to selecting an AC system vendor and implementation in 2024. By utilizing a “one-click,” cloud based solution, a smooth integration was achieved requiring only a single day of vendor installation. A training program was facilitated by physics and delivered to CT simulation staff with regular, routine follow-up where changes to the workflow were discussed. These changes were developed based on feedback from Radiation Oncologists, dosimetry and physics. After completion of a planning CT-scan, the dataset is manually sent to the AC system via a DICOM export. Contours generated by the AC system are then manually reviewed and edited by CT simulation staff, prior to plan creation and publishing.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Initial investigations proved that contour accuracy and integrity between the AC system and those generated by radiation therapists were comparable. Furthermore, qualitative feedback from CT simulation and dosimetry staff indicates an increase in productivity and workflow improvement. Over-contouring by the AC system resulted in excessive contours requiring manual deletion prior to publishing. To address this, a batch deletion tool was developed and implemented early in the system's deployment. Another challenge was the AC system's shortcomings in handling brachytherapy patients. While this issue remains unresolved, efforts are ongoing in collaboration with the vendor to improve the AC system's use for this patient population. The AC system utilizes standardized templates to apply applicable contours, initial challenges did arise with wrong templates being applied by both CT simulation staff and the Radiation Oncologist. The frequency of this arising diminished over time with routine follow-up and additional training which included further transparency in mapped contour templates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;Addressing the challenges early on in the implementation of the AC system allowed for overall staff acceptance. The system is now used to automatically generate contours for planning CT scans that includes all treatment sites and urgency codes. The AC system has proven most effective for advanced palliative plans (VMAT), enabling quicker turnarounds on condensed timelines, while ma","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101947"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Patterns of Cannabis Consumption in Prostate Cancer Patients: a Canadian Cohort","authors":"Rachel Zhou ,&nbsp;Ihtisham Ahmad ,&nbsp;Hannah Jin ,&nbsp;Tara Rosewall","doi":"10.1016/j.jmir.2025.101928","DOIUrl":"10.1016/j.jmir.2025.101928","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Previous research has shown that cancer patients seek more information about cannabis use. Post legalization of cannabis in Canada has led way to a variety of products and formulations available to consumers. Our objective is to assess the prevalence of cannabis use among current and former prostate cancer patients at a single Canadian institution. We also seek to report trends in the methods and types of cannabis use. This data will help inform the development of educational resources for our patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;A web-based questionnaire was distributed to patients with a past or current prostate cancer diagnosis who are under care at three urology clinics within our Centre. The questionnaire collected demographic information and cancer diagnosis timeline, as well as alcohol, tobacco, and cannabis consumption patterns. Participants were accrued between June to October 2024. The study was approved by the institutional REB.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;562 responses with informed consent were received from 921 survey invitations (61% response rate). Participant surveys were excluded for multiple cancer diagnoses (44), incomplete, duplicate or inconsistent responses (73). A final sample of 445 participants were included. Survey responders who endorsed ever using cannabis were significantly younger than those who never used cannabinoid products (median age 67.365 ±0.935 vs. 70.1923 ±1.166 p=0.000214) and more likely to be Caucasian (OR=1.2, p∼0). A significantly greater proportion of cannabis users reported alcohol (p=0.002) and tobacco (p=0.018) consumption in past, present and frequent use categories. All cannabis users were further classified based on their consumption patterns: 21% had consumed some form of cannabis within the past 5 years, 12% had consumed within the last 5 months,17% consumed cannabis occasionally but not regularly, and 24% consumed daily for at least one year. Smoked (dried flower) was the preferred method of consumption for all cannabis ever-users (83%). Edibles, cannabis oils, and concentrates were also commonly preferred (42%, 21%, and 21% respectively), apart from infrequent users who have a low percentage of reported preferences in all other categories. The most reported cannabis content category was “mostly THC, with some CBD” (49%). The second most reported category was “I'm not sure,” (41%) which was most prevalent among infrequent users (71%) and reported by 26%, 20%, and 29% of past, recent, and frequent users, respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;The prevalence of cannabis use in our prostate cancer cohort is 12% in recent users. Participants prefer smoking (dried flower) with mostly THC and some CBD content, but a large sample also reported uncertainty of the content they are consuming. We conclude that the significant use of cannabinoids within this population cannot be overlooked and emphasize","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101928"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting in Line: Impact of Indexing on Treatment Setup Accuracy for Prostate Radiotherapy","authors":"Jennifer Dang ,&nbsp;Alvin Cuni ,&nbsp;Colin Robertson ,&nbsp;Vanessa Wan ,&nbsp;Tara Rosewall","doi":"10.1016/j.jmir.2025.101932","DOIUrl":"10.1016/j.jmir.2025.101932","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Patient positioning is vital to the accurate delivery of radiation therapy treatments, especially in the era of ultra-hypofractionation and stereotactic body radiotherapy (SBRT). Indexing immobilization devices improves positional consistency and may minimize setup errors. With daily onboard imaging, changes in positioning can be visualized and rectified translationally, however, rotations may not always be corrected without 6 degrees-of-freedom compliant linear accelerator beds. The purpose of this retrospective analysis is to determine whether utilizing indexing in patient positioning for prostate patients improves treatment setup in terms of rotations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;Images from prostate patients treated between August 2023 to November 2023 with indexed and unindexed immobilization were reviewed. All patients were positioned using two standard pillows under head, a thin mattress, and a black leg immobilizer. Indexing was achieved using an in-house fabricated bar mounted at specific coordinates on each tabletop. The mounting position acted as an anchor to fix the leg immobilizer, allowing a reference for the distance from the inferior aspect of the leg immobilization (bottom of the foot) to the set-up mark. Patient planning CTs and cone beam CTs (CBCTs) acquired daily before treatment were restored in the radiation therapy electronic medical records and re-matched to determine the extent of rotations in all three directions from set-up. Student t-test was used to determine differences between the cohorts.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;A total of 988 CBCTs were successfully restored and rematched. The study consisted of four cohorts: Patients treated to their primary disease and pelvic nodal volumes with indexing (Indexed_Pelvis, n=330) and without indexing (Unindexed_Pelvis, n=306), and patients treated to their primary disease only with indexing (Indexed_Prostate n=200), and without indexing (Unindexed_Prostate, n=152). The maximum rotation exhibited was 4 degrees in the pitch for patients with indexed immobilization, whereas the maximum rotation for the unindexed cohorts was 5.3 degrees. The average yaw from Index_Pelvis was statistically higher than Unindexed_Pelvis (meanIndexed_Pelvis = 0.57, meanUnindexed_Pelvis = 0.38, p&lt;0.001). The average pitch for Indexed_Pelvis was statistically lower than the average pitch for Unindexed_Pelvis (meanIndexed_Pelvis = 0.68, meanUnindexed_Pelvis = 1.29, p&lt;0.001). No statistical differences were found for the roll exhibited by the Indexed_Pelvis and Unindexed_Pelvis cohorts. All rotations for the Indexed_Prostate group were statistically lower than the Unindexed_Prostate group (yaw: meanIndexed_Prostate = 0.32, meanUnindexed_Prostate = 0.46, p&lt;0.001; pitch: meanIndexed_Prostate = 0.64, meanUnindexed_Prostate = 1.17, p&lt;0.001; roll meanIndexed_Prostate = 0.37, meanUnindexed_Prostate = 1.0, p&lt;0.001).&lt;/div","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101932"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ready for the Big Time: Provincial Formalization of an APRT(T) Class of Practice","authors":"Carol-Anne Davis ,&nbsp;Darby Erler ,&nbsp;Susan Fawcett ,&nbsp;Gillian Graham ,&nbsp;Donna Lewis ,&nbsp;Fiona Mitchell ,&nbsp;Natalie Rozanec ,&nbsp;Christopher Topham ,&nbsp;Nicole Harnett","doi":"10.1016/j.jmir.2025.101957","DOIUrl":"10.1016/j.jmir.2025.101957","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;The growth of advanced practice in radiation therapy requires pan-Canadian infrastructure to standardize, streamline, and incentivize related roles across the country. A national certification model that certifies advanced radiation therapy practice has been in place since 2017, administered by the Canadian Association of Medical Radiation Technologists (CAMRT). This confers the protected title of Advanced Practice Registered Technologist (Therapy), or APRT(T), on those meeting the requirements. The next logical step in solidifying safe and standardized advanced practice is to define a separate regulatory class for APRT(T)s in provinces where regulation of medical radiation technology (MRT) professions exists. The CAMRT convened a task group of radiation therapists with expertise in advanced practice and issues of self-regulation in Ontario, Alberta, British Columbia (BC), and Nova Scotia, to prepare the way for future action on extended class practice for APRT(T)s.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;The CAMRT APRT(T) Regulation &amp; Legislation Task Group set out to accomplish three tasks: 1)\tDefine the specific tasks and responsibilities that distinguish advanced practice from standard practice in radiation therapy, as it relates to formal regulated scopes of practice in each Ontario, Alberta, and Nova Scotia, and future regulation in BC. 2)\tEnlist the preliminary support of provincial regulatory bodies and other stakeholders for the Task Group work to define a separate regulatory class for APRT(T)s 3)\tMap provincial legislative and regulatory processes and prepare evidence and materials to formalize the new APRT(T) role Using the national APRT(T) competency profile, provincial legislation that defines controlled acts, restricted activities, and profession-specific regulations (depending on the province), and an inventory of medical directives and delegations held by currently certified APRT(T)s, the Task Group identified the areas where legislative and regulatory change would be required to formalize an APRT(T) class of practice. Following relevant guidance, documentation was prepared to initiate the process to create a separate class in each province.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Recognizing a separate class of practice for APRT(T) will support consistent and sustainable implementation of this important role. APRT(T)s will be able to practice autonomously and to full scope without additional delegations, medical directives or support structures. A separate category of self-regulated practice may also incentivize centres to invest in new models of care that involve APRT(T)s. More importantly, in the interest of public safety, it will ensure that engagement in an advanced scope of radiation therapy practice is restricted to those formally confirmed to have the requisite knowledge, skills, and judgement through national certification. The differences in provincial legislatio","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101957"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the Field: Estimating Ontario's MR Simulation Requirements Using RT-QBP Data","authors":"Nareesa Ishmail ,&nbsp;Angelica Ramprashad ,&nbsp;Eric Gutierrez ,&nbsp;Kristin Berry ,&nbsp;Brian Liszewski ,&nbsp;Jason Pantarotto","doi":"10.1016/j.jmir.2025.101951","DOIUrl":"10.1016/j.jmir.2025.101951","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>The use of magnetic resonance simulation (MR-SIM) in Radiation Therapy has increased over the last decade, however there is significant variation in access across the province. MR-SIM is an evolving strategy in radiation treatment planning, deemed essential for some disease sites while not adding value in others. Ontario Health (Cancer Care Ontario) initiated a project to determine when MR-SIM is most beneficial based on clinician feedback identifying disease site groups and specific Radiation Treatment Quality Based Protocols that will benefit from MR-SIM.</div></div><div><h3>Methods/Process</h3><div>Since the implementation of Radiation Treatment-Quality Based Procedures (RT-QBP) funding in 2019, the Radiation Treatment Program (RTP) at Ontario Health (Cancer Care Ontario) has been receiving protocol level information on every patient receiving radiation treatment in Ontario. RT-QBP data includes significant amounts of information including but not limited to disease site groups, sub-groups, intent (primary or metastatic), treatment modality (external beam, brachytherapy etc.), and even dose and fractionation. In March 2024, RT-QBP protocol lists were shared with various disease site experts to identify protocols that would require or benefit from MR-SIM.</div></div><div><h3>Results or Benefits/Challenges</h3><div>Upon review of RT-QBP protocols by disease site experts, the top 5 sites that benefit from MR-SIM include Head and Neck, Sarcoma, Central Nervous System, Gynecology and Genitourinary. The percentage of protocols that benefit ranged from 73% to 94%. Currently 4 of 16 radiation treatment facilities in the province have access to dedicated MR-SIM with the remaining sites gaining access through Diagnostic Imaging in various capacities, demonstrating the need for a strategic plan to ensure equitable access to aid improved accuracy in radiation treatment planning. This plan may include increasing MR-SIM access for centres with higher volumes or a shared resource approach for smaller centres that may not be able to fully utilize the capacity on MR-SIM. This work requires support from multiple programs and interprofessional partners.</div></div><div><h3>Conclusions/Impact</h3><div>This work may lead to new quality indicators for Radiation Therapy treatment, with MR-SIM being one of many possible quality indicators for treatment. A refined approach is necessary to determine the next steps. However, the impact of increasing access to MR-SIM for patients is far reaching and the implementation of RT-QBP reporting can be leveraged to streamline the approach.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 1","pages":"Article 101951"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}